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Scrubby foliage hide the entryway. One sloping timber tunnel leads down to a well-illuminated welcome zone. Inside lies a surgery unit, outfitted with gurneys, heart rate sensors and breathing machines. Plus shelves full of medical equipment, medications and organized stacks of extra garments. In a staff room with a laundry appliance and hot water heater, physicians keep an eye on a screen. The screen reveals the flight patterns of Russian surveillance UAVs as they weave in the sky above.

Hospital personnel at an underground medical center look at a monitor showing enemy suicide and reconnaissance UAVs in the region.

Welcome to Ukraine’s secret underground hospital. The facility opened in the eighth month and is the second of its kind, situated in eastern Ukraine close to the frontline and the urban area of Pokrovsk in Donetsk oblast. “Our facility sits 6 metres under the earth. It’s the safest way of delivering care to our wounded soldiers. It also ensures medical personnel protected,” stated the clinic’s lead doctor, Major Oleksandr Holovashchenko.

This medical station handles thirty to forty patients a each day. Cases differ widely. Some have devastating limb trauma necessitating amputations, or severe stomach wounds. Others can move on their own. The vast majority are the casualties of enemy FPV aerial devices, which drop explosives with lethal accuracy. “Ninety per cent of our patients are from FPVs. We encounter minimal gunshot wounds. It’s an age of unmanned aircraft and a different kind of war,” the doctor explained.

Maj Oleksandr Holovashchenko at the underground facility for treating injured troops in eastern Ukraine.

On one afternoon recently, three military members limped into the hospital. The most lightly injured, twenty-eight-year-old Artem Dvorskyi, said an FPV blast had torn a small hole in his leg. “War is terrible. The guy beside me, Vasyl, was killed,” he said. “He collapsed. Subsequently the Russians released a another explosive on him.” He added: “Everything in the village is demolished. We see UAVs everywhere and bodies. Ours and the enemy's.”

The soldier said his squad endured over a month in a forest area near the city, which enemy forces has been attempting to capture for many months. Sole access to reach their location was on foot. All supplies arrived by drone: food and water. A week after he was injured, he walked 5km (roughly three miles), taking several hours, to a point where an armoured vehicle was able to pick him up. Upon arrival, a medic checked his vital signs. After treatment, a nurse provided him with new non-military attire: a T-shirt and a set of light-colored denim trousers.

The soldier, 28, stated a FPV drone caused a small hole in his lower limb.

Another patient, 38-year-old Pavlo Filipchuk, said a drone blast had left him with a head injury. “I was in a trench shelter. Suddenly it went dark. I lost sensation any feeling or any sound,” he said. “I think I was lucky to remain alive. My cousin has been killed. There are ongoing explosions.” A builder working in Lithuania, Filipchuk noted he had returned to his homeland and enlisted to serve days before the Russian leader's full-scale invasion in early 2022.

A third soldier, a serviceman, had been struck in the upper body. He expressed pain as doctors placed him on a bed, took off a stained bandage and cleaned his recent shrapnel wound. Wrapped in a thermal sheet, he used a cellphone to ring his sister. “A piece of mortar hit me. It was a deflected projectile. I’m OK,” he told her. What comes next for him? “To recover. That will take a few months. Subsequently, to return to my military group. Our forces must protect our nation,” he affirmed.

Medical staff care for Taras Mykolaichuk, who was hit in the dorsal area by a fragment of mortar.

Since 2022, Russia has repeatedly attacked hospitals, health facilities, maternity wards and emergency vehicles. According to human rights groups, 261 medical personnel have been killed in almost two thousand assaults. This subterranean hospital is constructed from four steel bunkers, with timber beams, soil and granular material laid on top up to the surface. It can withstand impacts from large-caliber artillery shells and even three 8kg explosive devices released by drone.

The Ukrainian steel and mining company, which financed the building, plans to build 20 facilities in total. The head of the nation's national security council and former defence minister, Rustem Umerov, declared they would be “vitally important for preserving the survival of our military and assisting defenders on the battlefront.” The company described the project as the “largest-scale and demanding” it had implemented since Russia’s invasion.

An example of the centre’s operating theatres.

Holovashchenko, explained some wounded soldiers had to endure delays hours or even multiple days before they could be transported due to the threat of air assaults. “We had two critically ill casualties who arrived at 3am. It was necessary to carry out a double amputation on one of them. His tourniquet had been applied for so long there was no other option.” What is his method with severe operations? “I’ve been medicine for two decades. You have to concentrate,” he said.

Orderlies wheeled Mykolaichuk up the tunnel and into an emergency vehicle. The transport was parked under a shrub. The patient and the other soldiers were transferred to the urban center of a major city for additional medical care. The underground medical team paused for rest. The hospital’s orange feline, the mascot, walked up to the doorway to await the next arrivals. “Our facility operates active 24 hours a day,” the surgeon stated. “It doesn’t stop.”